| Organization Name: | PHIL TYREE DDS PC |
| NPI Number: | 1326129768 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHIL J TYREE (OWNER) |
| Mailing Address: | 201 N Hinckley St Holdenville |
| State: | OK US |
| Postal Code: | 748485449 |
| Phone Number: | 4053796695 |
| Fax Number: | 4053796923 |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 4007 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |